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Background Identifying and treating people in a pre-frail state may be an effective way to prevent or delay frailty and preserve their functional capacity. This study aimed to assess the efficacy of, and compliance with, a 12 week individualized nutritional supplementation (INS) and Nordic walking (NW) program in pre-frail older Indians. The primary measure is physical performance, as indicated by Fried’s Frailty scale. Other measures include: cognition, as indicated by the Hindi Mental Status Examination; mood, by the Geriatric Depression Scale; and nutritional status, by the Mini Nutritional Assessment. Methods This is an open-labeled experimental pre-test and post-test study, which took place from October 2012 to December 2014. The study was approved by Institute Ethics committee (IEC/NP-350/2012/RP-26/2012) at the All India Institute of Medical Sciences (AIIMS), New Delhi. Participants were sixty-six pre-frail elderly, who were randomly allocated into three subgroups, namely: A (NW only), B (INS only), and C (NW and INS). One-way ANOVA was used to statistically assess differences in baseline characteristics for quantitative variables, with the Chi-Square/Fischer exact test utilized for qualitative variables. Paired t-tests were used to assess pre and post intervention difference within the group for quantitative variables, with McNemar’s Chi-Square test used for qualitative variables. Kruskal Wallis test was used to assess significant intervention effects among the groups. A p -value < 0.05 was considered as statistically significant. Results There was significant effect of intervention in gait speed in group A ( p  = 0.001) and C ( p  = 0.002), but not in group B ( p  = 0.926). While there was no significant change in grip strength in Group A ( p  = 0.488) and B ( p  = 0.852), a statistically significant increase was observed in group C ( p  = 0.013). Mood significantly improved in group B ( p =  0.025) and C (p  = 0.021). No significant difference was noted in cognitive status across groups. Following the interventions, a total of 18.18% of pre-frail participants were classified as non-frail. Conclusions Combining NW and INS provides a simple, pragmatic intervention with efficacy in the management of functionally vulnerable older adults, and allows their maintained independence. Future studies should replicate this readily applicable intervention in a larger cohort with a longer follow-up period. Trial registration Clinical Trial Registry-India CTRI/2016/05/006937 [Registered on: 16/05/2016]; Trial was Registered Retrospectively.

Post-Independence India adopted a highly controlled economic regime, with a closed economy and an emphasis on central planning. However, by the 1980s, policy-makers had realized the adverse effects of such a highly regulated system. In the early 1990s, an ambitious and comprehensive set of liberalization reforms was implemented, triggered primarily by a foreign exchange crisis. This paper critically evaluates these reforms. [PUBLICATION ABSTRACT]

Agriculture 5.0 is a principal economic activity in the world with major workforce dependent crops cultivation. An automated system for crops field insect pest identification can help decrease labour, while also improving the speed and precision in compared to manual methods. Less computation and memory systems are getting utilized for remote deployments of classification systems. In this paper, efficient pretrained multiple deep learning models based visual feature extraction and Linear Discriminant Analysis (LDA) based feature selection to provide high efficacy with light resource requirements. This proposed approach also able to handle large number of classes. To achieve this, diverse pest datasets were combined including 9 and 12 classes respectively and the utilized combined dataset contains total 19 classes. Methodology of proposed system included the selection of multiple pretrained models including DenseNet201, EfficientNetB3 and InceptionResNetV2 based on less memory and less parametric requirements. The second last layer of mentioned models have been utilized for selection of features as DenseNet201, EfficientNetB3 and InceptionResNetV2 resulted 1920, 1536 and 4608 accordingly. The extracted features combined and selected using LDA according to the number of classes. At end a basic light dense neural network have been deployed for classification. This makes a low resource and high efficacy pest classification model for higher number of classes. The results obtained by proposed technique are 99.99% Accuracy, 100% validation, 99.99% Recall and negligible Loss. Further the proposed system has been analysed and compared with benchmark approaches including transfer learning and single model feature extraction and selection approach. The main advantage of our proposed hybrid feature selection is that it makes the classification process lighter because it involves selecting relevant features from the existing dataset without training additional models, whereas transfer learning typically involves retraining or fine-tuning pre-existing models, which can be more computationally intensive. Overall the proposed system and approach resulting higher results with lighter process resources that fitted better in the development of domain of precision agriculture.

A new Global Investment Framework for Women's and Children's Health demonstrates how investment in women's and children's health will secure high health, social, and economic returns. We costed health systems strengthening and six investment packages for: maternal and newborn health, child health, immunisation, family planning, HIV/AIDS, and malaria. Nutrition is a cross-cutting theme. We then used simulation modelling to estimate the health and socioeconomic returns of these investments. Increasing health expenditure by just $5 per person per year up to 2035 in 74 high-burden countries could yield up to nine times that value in economic and social benefits. These returns include greater gross domestic product (GDP) growth through improved productivity, and prevention of the needless deaths of 147 million children, 32 million stillbirths, and 5 million women by 2035. These gains could be achieved by an additional investment of $30 billion per year, equivalent to a 2% increase above current spending.

[...]the Every Woman Every Child movement attracted more than US$60 billion dollars to women's and children's health between 2010 and 2015, with commitments from over 300 partners.6 The movement has spurred partnership mechanisms to support country-led implementation of the global strategy (2016-2030) - including the Global Financing Facility in support of Every Woman Every Child, the Innovation Marketplace, Unified Accountability Framework and the UN system's health agencies' H6 partnership.1 The global strategy (2016-2030) recognizes that human rights and other fundamental development principles - such as equity, community ownership and development effectiveness - are drivers of transformative change.1 In Peru, principles of equity underpinned a programme of poverty mapping to identify and prioritize reaching poor, rural and indigenous populations with social protection programmes and culturally appropriate, affordable care.7 In Kenya, the institutionalization of human rights principles is benefiting women's health following complaints alleging systematic violation of women's reproductive health rights in health facilities.

Background & objectives: Majority of the studies of hospital-acquired diarrhoea conducted in Western countries have focused on the detection of Clostridium difficile in stool samples. Limited Asian and Indian literature is available on hospital-acquired diarrhoea. This study was aimed to describe the aetiological profile for hospital-acquired diarrhoea in children aged below five years. Methods: One hundred children aged one month to five years who developed diarrhoea (≥3 loose stools for >12 h) after hospitalization for at least 72 h were enrolled. Children who were prescribed purgatives or undergoing procedures such as enema and endoscopy or those with underlying chronic gastrointestinal disorders such as celiac disease and inflammatory bowel disease were excluded from the study. Stool samples from the enrolled children were subjected to routine microscopic examination, modified Ziel-Nielson (ZN) staining for Cryptosporidium and culture for various enteropathogens. Multiplex PCR was used to identify the strains of diarrhoeagenic Escherichia coli. Rotavirus detection was done using rapid antigen kit. Toxins (A and B) of C. difficile were detected using enzyme immunoassay. Results: Of the 100 samples of hospital-acquired diarrhoea analysed, diarrhoeagenic E. coli (DEC) was found to be the most common organism, detected in 37 per cent of cases (enteropathogenic E. coli-18%, enterotoxigenic E. coli-8%, enteroaggregative E. coli-4% and mixed infections-7%). Cryptosporidium was detected in 10 per cent of cases. Rotavirus was detected in six per cent and C. difficile in four per cent of cases. Interpretation & conclusions: The findings of this study suggest that the aetiological profile of hospital-acquired diarrhoea appears to be similar to that of community-acquired diarrhoea, with DEC and Cryptosporidium being the most common causes. The efforts for the prevention and management of hospital-acquired diarrhoea should, thus, be directed towards these organisms.

Enterobius vermicularis (EV), an intestinal nematode, causes lesions at ectopic sites also. Although lesions are fully curable with antihelminthic drugs, patients may require surgical intervention in clinically unsuspected cases to arrive at correct diagnosis and appropriate treatment. Accurate diagnosis of these lesions on fine needle aspiration cytology (FNAC) has an advantage of avoiding unwanted surgery. To the best of our literature search, there are few case reports of EV diagnosed on cytology, but none of them describes the various stages of development of eggs and hatching of larvae. Dealing cytopathologist should be cognizant of them as parasite can be present in any of these forms/stages. Recently, we came across an interesting case of young boy who presented with perineal nodule and on FNAC from the lesion showed EV larvae and its eggs in various stages of hatching and development. The patient responded to antihelminthic treatment (AHT). Morphological clues with a review of cytological literature are discussed.

Background: Intraoperative evaluation of an ovarian mass is of crucial importance in its further management, accomplished by frozen section (FS) and scrape smear (SS) examination. Aim: To evaluate utility of SS over FS and to study scrape cytological features of a variety of ovarian neoplasms. Materials and Methods: The study comprised ovarian tumors studied over a period of 1 year (2014-2015) that were submitted for intraoperative assessment. SS and FS were examined and evaluated independently. The results were compared with final pathological diagnosis in each case, and cases with discordant diagnoses were reviewed. All the SSs of ovarian tumors were re-evaluated with Giemsa-stained smears, and cytological features were described. Results: The results of SS and FS were 100% concordant. On histopathology, of 81 cases, 43 were epithelial [(categorized further as serous, mucinous, or malignant mixed Mullerian tumor (MMMT)] along with subcategorization of benign, borderline, and malignant), 16 were germ cell (categorized as teratoma: mature/immature and yolk sac tumor), 11 were sex cord stromal tumors (fibroma, granulosa cell tumor, Sertoli-Leydig cell tumor), 8 cases were hemorrhagic cysts (torsion, endometroid, corpus luteal cyst, etc.), and 3 were metastasis. There were 61 benign, 2 borderline, and 18 malignant cases on FS and scrape. Combining all the values, sensitivity and specificity were 76% and 98.21%, respectively. The diagnostic accuracy in diagnosing malignant lesions was 91%. Conclusion: Adequate knowledge on cytohistological correlation of ovarian scrape cytology may phase out the use of cryostat in intraoperative diagnosis of ovarian neoplasms, and thus be a boon for resource-deprived settings.

The present study entitled \"Pathomorphological and Immunological Assessment of ZnO nanoparticles induced hepatic toxicity in male wistar rats\" was undertaken. For this purpose, a total of 72 rats were randomly divided into four equal groups. The rats of group I were given normal basal feed and water as they served as control rats. The rats of Group II, III & IV were given aqueous solution of ZnO nanoparticles orally at the dose rate of 800 mg/kg BW, 400 mg/kg BW & 200 mg/kg BW, respectively. The histopathological alterations and immunological alterations were recorded at the intervals 15-, 30- and 45-days exposure of experimentation. Grossly, no marked changes were evident in liver of any treatment group upto 30 days of exposure period. Slight paleness was evident in liver at 45 days of exposure period. Histopathologically, normal histoarchitecture of hepatocytes was evident in all groups upto 15 days of exposure. Thereafter, cellular swelling, hydropic degeneration, focal necrosis and increased sinusoidal spaced were evident in liver of rats of groups II & III after 30 days. Hepatic IL-6 revealed a significant increase in group II after 30 days, while significant increase was evident in both groups II & III after 45 days of exposure. TNF-α increased significantly in group II in hepatic tissue after 30 days, while significant increase was evident in both groups II & III post 45 days of exposure. Based on the results of this study, it was concluded that ZnO nanoparticles caused sub-acute toxicity at doses above 200mg/kg.